Fillable EDI and Web Filers Distributors GALLONAGE TAX REMITTANCE (Kansas Department of Revenue)

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EDI and Web Filers Distributors GALLONAGE TAX REMITTANCE (Kansas Department of Revenue)

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A
LCOHOLIC BEVERAGE CONTROL
109 SW 9
th
STREET
P.O. BOX 3506
T
OPEKA KS 66601-3506
☐
$
$
$
$
$
$
$
STATE OF KANSAS
DEPARTMENT OF REVENUE
P
HONE: 785-296-7015
F
AX: 785-296-7185
www.ksrevenue.org/abc.html
ALCOHOLIC BEVERAGE CONTROL
GALLONAGE TAX REMITTANCE VOUCHER
Distributors’
EDI and Web Filers
MONTH: YEAR: FEIN: -
TODAY’S DATE:
DISTRIBUTOR NAME:
LICENSE NUMBER:
CONTACT PERSON:
EMAIL ADDRESS:
I have filed my Liquor Enforcement Tax Return electronically.
GALLONAGE TAX PAYMENT DISTRIBUTION
PRODUCT TYPE: DEPOSIT CODE: TAX AMOUNT DUE:
Alcohol and Spirits (GLAS)
Fortified Wine (FWGL)
Light Wine (LWGL)
Beer (GLBR)
Cereal Malt Beverage (MBTX)
Flavored Malt Beverage – Strong (GFMB)
Flavored Malt Beverage – Weak (FMBT)
TOTAL REMITTANCE = $
ABC-216 (Rev. 02/18)
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EDI and Web Filers Distributors GALLONAGE TAX REMITTANCE (Kansas Department of Revenue)

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Completed 24 August 2020

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